Table of Contents

Understanding and preventing the 10 most common injuries suffered by triathletes.

Physical therapy for athletes has evolved in the past decade with a shift in understanding where the root causes lie and how to best deal with them. Gone are the days when everything could be cured by orthotics; now more attention is on hip strength, mobility and practicing good technique when you swim, bike or run.

We talked to four top sports physical therapists from around the country (read about them on page 80) and got their insight on which injuries might be lurking around the corner—and how you can prevent them in the first place.

Shoulder impingement

The deal: “Somewhat obviously, this is usually an overuse injury from swimming,” says Nate Koch. “It’s a result of improper biomechanics resulting in the stroke technique being off: The swimmer may not be using enough body roll and the reach isn’t proper.” Koch says that the internal rotation of the arm compresses tendons and bursa. A sign of shoulder impingement is that the morning after a hard swimming workout you wake up and your shoulder is sore.

First aid: “Lots of people don’t want to miss workouts,” Koch says. “The coach has it on the schedule and they can’t bring themselves to take the break.” But rest is exactly what you should do, Koch explains. Because an impingement comes from tightness and lack of “space” in the shoulder, work on mobility around both the shoulder blade and scapula.

Prevention: In addition to refining your stroke mechanics, consistent mobility and flexibility in the shoulder complex is the No. 1 prevention tool. Koch says to follow the example of most collegiate swimmers and spend time before and after each swim workout performing simple rotator cuff and mid-back mobility exercises to help counter all of the muscular imbalance created during a swim workout.